KL-6聯合肺功能在多發性肌炎/皮肌炎合并間質性肺疾病中的應用價值_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

劉媛媛 , 李艷菊 , 馬鳳蓮 , 陳旭 , 陳曦 , 嚴曉旭 , 張明珠 , 謝靜 , 楊慧 ,  郭東更

寧夏回族自治區人民醫院寧夏醫科大學附屬自治區人民醫院風濕免疫科寧夏回族自治區精準醫學重點實驗室（寧夏銀川 750001）;

Corresponding?author：

郭東更, Email: guodonggeng@126.com

Keywords：

KL-6; 肺功能; 間質性肺疾病; 多發性肌炎; 皮肌炎

DOI：

10.7507/1671-6205.202306018

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探討血清KL-6和肺功能檢測在多發性肌炎（polymyositis，PM）/皮肌炎（dermatomyositis，DM）合并間質性肺疾病（interstitial lung disease，ILD）中的臨床應用價值。方法采用回顧性分析，納入初發PM/DM患者（n=64）臨床資料，分為間質肺組（n=40）和無間質肺組（n=44），另選健康對照組40例，比較三組患者血清KL-6水平及肺功能在兩組的差異并分析其在PM/DM-ILD組中的應用價值。結果間質肺組患者KL-6水平明顯高于無間質肺組（P<0.01）；間質肺組患者VC%pred、MVV%pred、FEV₁%pred、D_LCO%pred、D_LCO/VA%pred、TLC%pred均低于無間質肺組（P均<0.05）；ROC曲線分析得出PM/DM患者中血清KL-6診斷ILD敏感性為84%，特異性為87.5%，D_LCO%pred診斷ILD的敏感性為97.7%，特異性為57.5%，而二者聯合檢測敏感性為90.5%，特異性為82.5%；間質肺組血清KL-6與VC%pred、MVV%pred、FVC%pred、FEV₁%pred、D_LCO%pred成反比，與FEV₁/FVC%pred成正比（P均<0.05）；PM/DM發生ILD的危險因素：AST降低、KL-6升高及D_LCO%pred降低。結論 PM/DM患者聯合檢測血清KL-6和肺彌散功能可提高ILD診斷效能，KL-6和肺功能可能預測ILD的發生及疾病活動度，可指導臨床。

Citation： 劉媛媛, 李艷菊, 馬鳳蓮, 陳旭, 陳曦, 嚴曉旭, 張明珠, 謝靜, 楊慧, 郭東更. KL-6聯合肺功能在多發性肌炎/皮肌炎合并間質性肺疾病中的應用價值. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(12): 878-883. doi: 10.7507/1671-6205.202306018 Copy

1.	Kliment CR, Englert JM, Gochuico BR, et al. Oxidative stress alters syndecan-1 distribution in lungs with pulmonary fibrosis. J Biol Chem, 2009, 284(6): 3537-45.
2.	史洪博, 卡德力亞, 趙丹. 抗Jo-1抗體、抗SSA/Ro52抗體陽性的多發性肌炎/皮肌炎臨床特征分析. 檢驗醫學與臨床, 2021, 18(13): 1879-1882.
3.	劉曉陽, 戴麗, 程洋. 多發性肌炎和皮肌炎相關間質性肺疾病的臨床特征分析. 北京醫學, 2022, 44(2): 108-113.
4.	Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med, 1975, 292(7): 344-347.
5.	Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med, 2013, 188(6): 733-748.
6.	Kohno N, Kyoizumi S, Awaya Y, et al. New serum indicator of interstitial pneumonitis activity. Sialylated carbohydrate antigen KL-6. Chest, 1989, 96(1): 68-73.
7.	Nakajima H, Harigai M, Hara M, et al. KL-6 as a novel serum marker for interstitial pneumonia associated with collagen diseases. J Rheumatol, 2000, 27(5): 1164-1170.
8.	He QR, Tang YF, Huang J, et al. The value of KL-6 in the diagnosis and assessment of interstitial lung disease. Am J Transl Res, 2021, 13(8): 9216-9223.
9.	侯俊, 閆淯淳, 蘇改秀, 等. 抗黑色素瘤分化相關基因蛋白5抗體與幼年皮肌炎間質性肺病嚴重程度的關系. 中華醫學雜志, 2021, 101(33): 2606-2610.
10.	Hu C, Wu C, Yang E, et al. Serum KL-6 is associated with the severity of interstitial lung disease in Chinese patients with polymyositis and dermatomyositis. Clin Rheumatol, 2019, 38(8): 2181-2187.
11.	劉玉夢, 許愛國, 趙玉苗, 等. 血清KL-6對多發性肌炎/皮肌炎合并肺部疾病的臨床價值. 中國實用醫刊, 2017, 44(10): 10-12.
12.	Hanaoka M, Katsumata Y, Kawasumi H, et al. KL-6 is a long-term disease-activity biomarker for interstitial lung disease associated with polymyositis/dermatomyositis, but is not a short-term disease-activity biomarker. Mod Rheumatol, 2019, 29(4): 625-632.
13.	吳雪, 武麗君, 羅采南等. 涎液化糖鏈抗原-6在結締組織病相關間質性肺病診斷中的應用價值. 中華醫學雜志, 2019, 99(40): 3172-3175.
14.	Lee JS, Lee EY, Ha YJ, et al. Serum KL-6 levels reflect the severity of interstitial lung disease associated with connective tissue disease. Arthritis Res Ther, 2019, 21(1): 58.
15.	Rai M, Parthasarathi A, Beeraka NM, et al. Circulatory Serum Krebs von Den Lungen-6 and Surfactant Protein-D Concentrations Predict Interstitial Lung Disease Progression and Mortality. Cells, 2023, 12(9): 1281.
16.	孫迪, 程哲, 蔣天賜, 等. 肺功能和KL-6在抗合成酶綜合征相關間質性肺疾病與特發性肺纖維化中的特點及臨床意義. 中華醫學雜志, 2020, 100(10): 748-752.
17.	Li T, Tang ZY, Zhang QB, et al. Clinical Characteristics and Risk Factors of Polymyositis and Dermatomyositis Combined with Interstitial Lung Disease in Patients Residing in the Northeast Sichuan Province of China. Curr Rheumatol Rev, 2023, 19(4): 455-462.

1. Kliment CR, Englert JM, Gochuico BR, et al. Oxidative stress alters syndecan-1 distribution in lungs with pulmonary fibrosis. J Biol Chem, 2009, 284(6): 3537-45.
2. 史洪博, 卡德力亞, 趙丹. 抗Jo-1抗體、抗SSA/Ro52抗體陽性的多發性肌炎/皮肌炎臨床特征分析. 檢驗醫學與臨床, 2021, 18(13): 1879-1882.
3. 劉曉陽, 戴麗, 程洋. 多發性肌炎和皮肌炎相關間質性肺疾病的臨床特征分析. 北京醫學, 2022, 44(2): 108-113.
4. Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med, 1975, 292(7): 344-347.
5. Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med, 2013, 188(6): 733-748.
6. Kohno N, Kyoizumi S, Awaya Y, et al. New serum indicator of interstitial pneumonitis activity. Sialylated carbohydrate antigen KL-6. Chest, 1989, 96(1): 68-73.
7. Nakajima H, Harigai M, Hara M, et al. KL-6 as a novel serum marker for interstitial pneumonia associated with collagen diseases. J Rheumatol, 2000, 27(5): 1164-1170.
8. He QR, Tang YF, Huang J, et al. The value of KL-6 in the diagnosis and assessment of interstitial lung disease. Am J Transl Res, 2021, 13(8): 9216-9223.
9. 侯俊, 閆淯淳, 蘇改秀, 等. 抗黑色素瘤分化相關基因蛋白5抗體與幼年皮肌炎間質性肺病嚴重程度的關系. 中華醫學雜志, 2021, 101(33): 2606-2610.
10. Hu C, Wu C, Yang E, et al. Serum KL-6 is associated with the severity of interstitial lung disease in Chinese patients with polymyositis and dermatomyositis. Clin Rheumatol, 2019, 38(8): 2181-2187.
11. 劉玉夢, 許愛國, 趙玉苗, 等. 血清KL-6對多發性肌炎/皮肌炎合并肺部疾病的臨床價值. 中國實用醫刊, 2017, 44(10): 10-12.
12. Hanaoka M, Katsumata Y, Kawasumi H, et al. KL-6 is a long-term disease-activity biomarker for interstitial lung disease associated with polymyositis/dermatomyositis, but is not a short-term disease-activity biomarker. Mod Rheumatol, 2019, 29(4): 625-632.
13. 吳雪, 武麗君, 羅采南等. 涎液化糖鏈抗原-6在結締組織病相關間質性肺病診斷中的應用價值. 中華醫學雜志, 2019, 99(40): 3172-3175.
14. Lee JS, Lee EY, Ha YJ, et al. Serum KL-6 levels reflect the severity of interstitial lung disease associated with connective tissue disease. Arthritis Res Ther, 2019, 21(1): 58.
15. Rai M, Parthasarathi A, Beeraka NM, et al. Circulatory Serum Krebs von Den Lungen-6 and Surfactant Protein-D Concentrations Predict Interstitial Lung Disease Progression and Mortality. Cells, 2023, 12(9): 1281.
16. 孫迪, 程哲, 蔣天賜, 等. 肺功能和KL-6在抗合成酶綜合征相關間質性肺疾病與特發性肺纖維化中的特點及臨床意義. 中華醫學雜志, 2020, 100(10): 748-752.
17. Li T, Tang ZY, Zhang QB, et al. Clinical Characteristics and Risk Factors of Polymyositis and Dermatomyositis Combined with Interstitial Lung Disease in Patients Residing in the Northeast Sichuan Province of China. Curr Rheumatol Rev, 2023, 19(4): 455-462.

Previous Article
Analysis of influencing factors of the awake prone position in patients with mild and moderate acute respiratory distress syndrome
Next Article
原發性纖毛運動障礙一例

Chinese Journal of Respiratory and Critical Care Medicine

KL-6聯合肺功能在多發性肌炎/皮肌炎合并間質性肺疾病中的應用價值

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content